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Assisted Household Bin Service Application Form

This application is for the City of Albany’s Assisted Household Bin Service for residents who are unable to move their household bins to the kerbside for collection. The service includes the collection of bins from, and their return to, an agreed location on the resident’s property.

PRIVACY COLLECTION NOTICE

The City of Albany collects your personal information to deliver services and meet our legal obligations under relevant laws.

We handle your information in line with the Privacy and Responsible Information Sharing Act 2024. Your information is stored securely, kept only as long as needed, and may be shared with other government agencies if required or permitted by law.

You can request access to, or correction of, your personal information at any time.

CONTACT

City of Albany Privacy Officer

Phone: 08 6820 3000

Email: [email protected] 

 

Secondary Contact

The City or their contractor may contact your Secondary Contact if required. 

Would you prefer all contact is directed to your Secondary Contact?*This field is required.
I own and reside at this property*This field is required.
I am a tenant at this property
Does the property have a steep or uneven driveway?
Bins must not be behind gates or at the rear of the property. Can the bins be placed in an area visible from the front of the property?*This field is required.
Proof of Eligibility

Proof of Eligibility

Confirmation that the applicant is unable to move their bins due to an ongoing or temporary medical issue by a qualified medical practitioner is required. The proof of eligibility should include the practitioner's name, service provider number, practice name and contact details. If the need is temporary, the document should indicate how long the service is required for. Specific details such as nature of medical issues or medical history are NOT required. 

NOTE: If your GP submits your proof of eligibility direct to the City of Albany you are not required to attach it here. Proof of eligibility can be submitted separately by email to [email protected], post to PO Box 484, ALBANY, WA 6331 or in person to the City of Albany Administration Offices at 102 North Road.

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx
Service Required (please check all that apply)*This field is required.
Is your need for the Assisted Household Service Temporary?
Declaration*This field is required.
Conditions

Conditions

  1. The City’s contractor must be able to access your bins safely to provide this service. Bins must be visible from the front of the property. Collection staff will not enter the rear of dwellings.
  2. The City’s contractor will use a sticker to identify your bins as part of this service.
  3. Bins must be maintained in good condition. Bin lids must be closed - overfull bins and additional waste next to bins will not be collected.
  4. While every care will be taken during the collection service, the City of Albany and its Contractor will not be liable for damage during provision of the service.
  5. Applications are not transferrable.
  6. The Applicant or Secondary Contact must advise the City of Albany on 6820 3000 or [email protected] if the Service is no longer required or if circumstances change. This includes change of address, extended periods of absence or new support from someone able to assist.
Proof of Eligibility

Confirmation that the applicant is unable to move their bins due to an ongoing or temporary medical issue by a qualified medical practitioner is required. The proof of eligibility should include the practitioner's name, service provider number, practice name and contact details. If the need is temporary, the document should indicate how long the service is required for. Specific details such as nature of medical issues or medical history are NOT required. 

NOTE: If your GP submits your proof of eligibility direct to the City of Albany you are not required to attach it here. Proof of eligibility can be submitted separately by email to [email protected], post to PO Box 484, ALBANY, WA 6331 or in person to the City of Albany Administration Offices at 102 North Road.

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